Client Evaluation Form

We at the Montreal Therapy Centre hope that we were able to provide you with the necessary services in order to help you overcome your problem. To ensure that we are providing the best service available we would appreciate it if you could take a few minutes to complete this form. Personal information is not to be given as this is an anonymous survey of our services.

*Name of Therapist

Rating
Please mark your response

Poor

Fair

Very good

1

2

3

4

5

Was your call or email answered quickly and courteously?12345

Were you referred to a therapist as promptly as you expected?12345

Was your therapist someone you felt comfortable with?12345

Did you feel like your therapist had a good understanding of the problem that brought you to therapy?12345

Was your therapist punctual and professional at all scheduled appointments?12345

Do you feel that the goals you had for therapy at the onset were adequately addressed?12345

Was your therapist able to help you as much as you expected?12345

How satisfied were you with the outcome of the therapeutic process?12345

Do you feel you now have the knowledge necessary to overcome your problem?12345

Would you recommend your therapist to others?12345

Overall, how would you rate the services you received?12345

Therapist's strengths

Anything that could be improved?

I acknowledge that my name will not be used in any way and I give my permission to have my above testimony anonymously used for promotional purposes on the Montreal Therapy website and other hard copy printed materials.